Vertebroplasty and kyphoplasty update.

Vertebroplasty and kyphoplasty are minimally invasive vertebral augmentation procedures in which a filler material is percutaneously injected into a vertebral body for the treatment of vertebral fractures associated with osteoporosis, malignant conditions, hemangiomas, and osteonecrosis. In vertebroplasty, the filler is injected directly into the bone, whereas in kyphoplasty, the filler is injected into a cavity created by inflation of a balloon tamp. The goals of treatment include pain relief, fracture stabilization, restoration of vertebral height, and strengthening of the vertebral body to reduce the risk of a future fracture at the same level. When performed by a well-trained physician in appropriately selected patients, vertebral augmentation is usually effective in achieving one or more of these goals, with a generally good short-term safety profile. Although these procedures hold great promise in the management of vertebral fractures, many questions about long-term efficacy and safety remain.